June 25, 2009

What If An Adolescent Has A Lump In Her Breast?

If a lump is found in the breast of an adolescent girl, she often will undergo an excisional biopsy.

However, breast cancer is rare in adolescents, and the vast majority of teenage breast lumps turn out to be benign masses that are related to hormones.

A recent Loyola University Health System study published in the American Journal of Roentgenology suggests that a breast ultrasound examination might eliminate the need for biopsy in many cases.

Loyola radiologists performed ultrasound examinations on 20 girls ages 13 to 19 who had lumps in their breasts, including one girl who had a lump in each breast. The ultrasound studies indicated that 15 of the 21 lumps appeared to be benign, while and six were suspicious.

Follow-up biopsies or clinical examinations found that all 21 lumps were benign. These findings suggest that if a breast ultrasound finds nothing suspicious, the patient likely does not need to have an excisional biopsy, said lead author Dr. Aruna Vade, a professor in the Department of Radiology at Loyola University Chicago Stritch School of Medicine.

In an excisional biopsy, the surgeon makes an incision along the contour of the breast and removes the lump. However, this procedure can be painful, change the shape of the breast and leave a small scar.

Vade and her colleagues indicated that excisional biopsies should be reserved for solid breast masses that are suspicious or show progressive growth or masses that are found in patients who are known to have a primary malignant tumor or family history of cancer. Their study is published in the September, 2008 issue of the American Journal of Roentgenology.

Among girls younger than 19, there are fewer than 25 cases of breast cancer per 100,000 per year, according to the National Cancer Institute.

The vast majority of breast lumps in adolescents are benign and tend to wax and wane. Over time, many disappear. Many teenage girls undergo biopsy of breast lumps because of parental anxiety and surgeons' concerns, Vade said.

Vade and colleagues wrote that for adolescents who present with solid masses that appear benign on ultrasound examination, "we conclude that excisional biopsy may not always be necessary."